Publications by authors named "Benjamin Essayagh"
Background: Left ventricular (LV) end-systolic enlargement in severe degenerative mitral-regurgitation (MR) is a class I surgical trigger. Whether it occurs disproportionately to less-than-severe MR due to mitral valve prolapse and is associated with mortality are unknown. We aimed to analyze prevalence and association with survival of disproportionate LV enlargement in less-than-severe MR.
View Article and Find Full Text PDFAims: Functional tricuspid regurgitation (FTR) associated with degenerative mitral regurgitation (DMR) accentuates the severity of heart failure and is a marker of poor prognosis. Little is known about FTR associated with asymptomatic DMR.
Methods And Results: The study included 1249 asymptomatic patients with moderate or severe DMR from the Mitral Regurgitation International Database-Quantitative (MIDA-Q) registry (mean age 64 ± 15 years, 25% female).
Background: The prevalence and impact of right ventricular dysfunction (RVD) in degenerative mitral regurgitation (DMR) is unknown. We aimed to determine whether RVD assessed by echocardiography in routine clinical practice is independently associated with mortality in patients with DMR.
Methods And Results: We used data from the MIDA-Q (Mitral Regurgitation International DAtabase-Quantitative) registry, which included patients with isolated DMR due to mitral valve prolapse from January 2003 to January 2020 from 5 tertiary centers across North America, Europe, and the Middle East.
Degenerative mitral stenosis by echocardiography: presentation and outcome.
Eur Heart J Cardiovasc Imaging
December 2024
Aims: Degenerative mitral stenosis (DMS) is due to degenerative mitral annular calcification (MAC) and valvular calcification. However, DMS impacts on the outcome, and therefore, potential treatment needs are poorly known. We aimed at evaluating survival after DMS diagnosis by Doppler echocardiography in routine practice.
View Article and Find Full Text PDFArticle Synopsis
- The study compares patients with degenerative mitral regurgitation (DMR) from Asian institutions (AsIs) and European/American institutions (EAIs) to understand differences in their presentation, management, and outcomes.
- AsI patients were generally younger, had fewer symptoms, and presented with smaller heart dimensions, yet underwent fewer interventions and experienced higher mortality rates compared to EAI patients.
- The findings suggest that imaging may not accurately reflect the severity of DMR in AsI patients due to their smaller body size, indicating a potential issue with under-treatment in this population.
Indexing left ventricular end-systolic dimension to body size: Association with mortality in patients with degenerative mitral regurgitation.
Eur J Heart Fail
December 2024
Aims: In patients with degenerative mitral regurgitation (DMR), left ventricular (LV) dysfunction is associated with increased risk of heart failure and excess mortality. LV end-systolic diameter (LVESD) is an established trigger for intervention, yet recommended LVESD thresholds apply poorly to patients with small body size. Whether LV normalization to body surface area (BSA) may be used as a trigger for DMR correction is unknown.
View Article and Find Full Text PDFSurvival loss linked to guideline-based indications for degenerative mitral regurgitation surgery.
Eur Heart J Cardiovasc Imaging
November 2024
Article Synopsis
- The study evaluated the long-term survival outcomes of 2833 patients with severe degenerative mitral regurgitation (DMR) who underwent surgical correction, guided by various surgical indications.
- Results indicated that patients classified under Class-I triggers experienced significantly lower postoperative survival rates compared to those under Class-IIa triggers or no triggers, with a median follow-up of 8.5 years showing a stark difference in survival percentages.
- Overall, operating on patients with Class-I criteria resulted in a considerable loss of postoperative survival time, suggesting that immediate surgery based on these guidelines may not be the best approach for improving long-term outcomes in DMR patients.
Reappraisal of the Concept and Implications of Pulmonary Hypertension in Degenerative Mitral Regurgitation.
JACC Cardiovasc Imaging
October 2024
Background: European and U.S. clinical guidelines diverge regarding pulmonary hypertension (PHTN) in degenerative mitral regurgitation (DMR).
View Article and Find Full Text PDFBackground And Aims: Presentation, outcome, and management of females with degenerative mitral regurgitation (DMR) are undefined. We analysed sex-specific baseline clinical and echocardiographic characteristics at referral for DMR due to flail leaflets and subsequent management and outcomes.
Methods: In the Mitral Regurgitation International Database (MIDA) international registry, females were compared with males regarding presentation at referral, management, and outcome (survival/heart failure), under medical treatment, post-operatively, and encompassing all follow-up.
Mitral Annular Disjunction in the Context of Mitral Valve Prolapse: Identifying the At-Risk Patient.
JACC Cardiovasc Imaging
October 2024
Mitral annular disjunction (MAD), a separation between the left atrium/mitral valve annulus and the left ventricular myocardium, is frequently seen in patients with arrhythmic mitral valve prolapse. Although an association exists between MAD and ventricular arrhythmias, little is known regarding the identification of individuals at high risk. Multimodality imaging including echocardiography, computed tomography, cardiac magnetic resonance, and positron emission tomography can play an important role in both the diagnosis and risk stratification of MAD.
View Article and Find Full Text PDFArticle Synopsis
- The study tracked the incidence of severe aortic stenosis (AS) in Olmsted County, MN, from 1997 to 2016, finding a stable rate of approximately 52.5 cases per 100,000 patients per year despite an increasing overall number due to population growth.
- Incidence trends revealed that while rates in men remained stable, there was a decline in women, indicating potential differences in disease presentation or diagnosis between genders.
- Aortic valve replacement (AVR) procedures became more timely over the two decades, associated with improved survival rates, but overall mortality rates after treatment remained high, highlighting ongoing challenges in managing severe AS.
The Arrhythmic Mitral Valve Prolapse: Still a Long Way to Go.
JACC Clin Electrophysiol
December 2023
Article Synopsis
- Mitral valve prolapse (MVP) is the most common valve disorder but is complex, especially concerning its association with arrhythmias (AMVP) and risks of sudden cardiac death.
- Recent studies reveal that MVP isn't always benign and can be linked to serious ventricular arrhythmias, necessitating a deeper understanding of AMVP and its characteristics.
- The review suggests a risk assessment strategy for managing patients with MVP by exploring mitral annular disjunction (MAD) and its implications, advocating for updated research and clinical guidelines.
Commentary: The newer the better is not always true in mitral valve repair.
J Thorac Cardiovasc Surg
October 2024
Arrhythmic mitral valve prolapse in 2023: Evidence-based update.
Front Cardiovasc Med
April 2023
Patients with mitral valve prolapse (MVP) may develop ventricular arrhythmias, ranging from premature ventricular contractions through more complex non-sustained ventricular tachycardia to sustained life-threatening ventricular arrhythmias. The prevalence of MVP in autopsy series of young adults who died suddenly has been estimated to be between 4% and 7%. Thus, "arrhythmic MVP" has been reported as an underappreciated cause of sudden cardiac death, leading to a renewed interest in the study of this association.
View Article and Find Full Text PDFAims: Indications for surgery in patients with degenerative mitral regurgitation (DMR) are increasingly liberal in all clinical guidelines but the role of secondary outcome determinants (left atrial volume index ≥60 mL/m2, atrial fibrillation, pulmonary artery systolic pressure ≥50 mmHg and moderate to severe tricuspid regurgitation) and their impact on post-operative outcome remain disputed. Whether these secondary outcome markers are just reflective of the DMR severity or intrinsically affect survival after DMR surgery is uncertain and may have critical importance in the management of patients with DMR. To address these gaps of knowledge the present study gathered a large cohort of patients with quantified DMR, accounted for the number of secondary outcome markers and examined their independent impact on survival after surgical correction of the DMR.
View Article and Find Full Text PDFBackground: Mitral valve prolapse (MVP) is responsible for a considerable disease burden but is widely heterogeneous. The lack of a comprehensive prognostic instrument covering the entire MVP spectrum, encompassing the quantified consequent degenerative mitral regurgitation (DMR), hinders clinical management and therapeutic trials.
Methods: The new Mitral Regurgitation International Database Quantitative (MIDA-Q) registry enrolled 8187 consecutive patients (ages 63±16 years, 47% women, follow-up 5.